Med Clin (Barc). 2007 Jan 13;128(1):1-6.
[Overexpression and prognostic value of p53 and HER2/neu proteins in benign ovarian tissue and in ovarian cancer]
[Article in Spanish]
Coronado Martin PJ, Fasero Laiz M, Garcia Santos J, Ramirez Mena M, Vidart Aragon JA.
Departamento de Obstetricia y Ginecologia, Hospital Clinico San Carlos, Martin Lagos s/n, 28040 Madrid, Spain. pcoronadom@sego.es
BACKGROUND AND OBJECTIVE: To investigate the prognostic value of p53 and HER2/neu overexpression in epithelial ovarian cancer (EOC). PATIENTS AND METHOD: p53 and HER2/neu immunostaining were performed in 198 tissue samples, 124 EOC, 44 benign ovarian tumors and 30 normal ovaries. Nuclear p53 and membranous HER2/neu immunostaining were evaluated. RESULTS: Neither p53 nor HER2/neu overexpression was seen in the benign ovarian tumors. HER2/neu immunostaining was observed in one normal ovary. P53 overexpression was found in 25% EOC and was related with advanced stage, endometrioid, clear cell and undifferentiated types, grade G3, and sub-optimal surgery. HER2/neu immunostaining was observed in 24.2% and it was associated with advanced stage, clear cell and undifferentiated types, and suboptimal surgery. Both, p53 and HER2/neu overexpression decreased overall and progression-free survival, but in the multivariant analysis, only HER2/neu overexpression was an independent prognostic factor of overall survival (RR = 2.8; 95% confidence interval [CI], 1.2-5.6) and recurrence (RR = 2.8; 95% CI, 1.1-7.1). Simultaneous p53 and HER2/neu overexpression made the prognosis worse (p < 0.01). CONCLUSIONS: HER2/neu overexpression (but not p53 overexpression) is a major prognostic factor in EOC.
Publication Types:
• Comparative Study
• English Abstract
PMID: 17266884 [PubMed - indexed for MEDLINE]
________________________________________
Int J Colorectal Dis. 2007 Jan 30; [Epub ahead of print]
High-grade endometrial stromal sarcoma arising from colon endometriosis.
Chen CW, Ou JJ, Wu CC, Hsiao CW, Cheng MF, Jao SW.
Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Road, Sec. 2, Taipei, 114, Taiwan, Republic of China, 1211cathy@yahoo.com.tw.
PMID: 17262201 [PubMed - as supplied by publisher]
________________________________________
Proc Natl Acad Sci U S A. 2007 Feb 6;104(6):1925-30. Epub 2007 Jan 29.
Noninvasive and real-time assessment of reconstructed functional human endometrium in NOD/SCID/gamma c(null) immunodeficient mice.
Masuda H, Maruyama T, Hiratsu E, Yamane J, Iwanami A, Nagashima T, Ono M, Miyoshi H, Okano HJ, Ito M, Tamaoki N, Nomura T, Okano H, Matsuzaki Y, Yoshimura Y.
Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Human uterine endometrium exhibits unique properties of cyclical regeneration and remodeling throughout reproductive life and also is subject to endometriosis through ectopic implantation of retrogradely shed endometrial fragments during menstruation. Here we show that functional endometrium can be regenerated from singly dispersed human endometrial cells transplanted beneath the kidney capsule of NOD/SCID/gamma(c)(null) immunodeficient mice. In addition to the endometrium-like structure, hormone-dependent changes, including proliferation, differentiation, and tissue breakdown and shedding (menstruation), can be reproduced in the reconstructed endometrium, the blood to which is supplied predominantly by human vessels invading into the mouse kidney parenchyma. Furthermore, the hormone-dependent behavior of the endometrium regenerated from lentivirally engineered endometrial cells expressing a variant luciferase can be assessed noninvasively and quantitatively by in vivo bioluminescence imaging. These results indicate that singly dispersed endometrial cells have potential applications for tissue reconstitution, angiogenesis, and human-mouse chimeric vessel formation, providing implications for mechanisms underlying the physiological endometrial regeneration during the menstrual cycle and the establishment of endometriotic lesions. This animal system can be applied as the unique model of endometriosis or for other various types of neoplastic diseases with the capacity of noninvasive and real-time evaluation of the effect of therapeutic agents and gene targeting when the relevant cells are transplanted beneath the kidney capsule.
Publication Types:
• Evaluation Studies
• Research Support, Non-U.S. Gov't
PMID: 17261813 [PubMed - indexed for MEDLINE]
________________________________________
Fertil Steril. 2007 Apr;87(4):982-4. Epub 2007 Jan 29.
Cognate chemokine receptor 1 messenger ribonucleic acid expression in peripheral blood as a diagnostic test for endometriosis.
Agic A, Xu H, Rehbein M, Wolfler MM, Ebert AD, Hornung D.
We investigated the expression of the cognate chemokine receptor 1 (CCR1) messenger ribonucleic acid, a G-protein-coupled cognate chemokine receptor with high affinity for RANTES (Regulated upon Activation, Normal T cells Expressed and Secreted), in peripheral blood leukocytes of women with and without endometriosis, and its potential use as a diagnostic test for endometriosis. Because patients with an earlier diagnosis of this disease have a better treatment outcome and a reduced recurrence rate, CCR1 mRNA measurement in the peripheral blood of patients with suspected endometriosis might give us a new perspective in diagnosing and treating this disease earlier and better.
Publication Types:
• Letter
PMID: 17261287 [PubMed - indexed for MEDLINE]
________________________________________
Acta Obstet Gynecol Scand. 2006;85(12):1506-7.
Ovarian clear cell carcinoma occurring in a young patient with endometriosis and long-term ovulation stimulations.
Saylam K, Devreker F, Simon P, Fayt I, Noel JC.
Department of Gynaecology and Obstetrics, Erasme Hospital, Universite Libre de Bruxelles, Bruxelles, Belgium. kezibansaylam@hotmail.com
Publication Types:
• Case Reports
PMID: 17260230 [PubMed - indexed for MEDLINE]
________________________________________
J Adolesc Health. 2007 Feb;40(2):151-7. Epub 2006 Nov 29.
Extended cycling of combined hormonal contraceptives in adolescents: physician views and prescribing practices.
Gerschultz KL, Sucato GS, Hennon TR, Murray PJ, Gold MA.
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
PURPOSE: We sought to determine the practices of physicians who prescribe for adolescents extended cycles of combined hormonal contraception, in which hormones are taken for longer than 21 days and menstruation is delayed. METHODS: Five hundred physicians from the membership rosters of the Society for Adolescent Medicine and the North American Society for Pediatric and Adolescent Gynecology were asked to complete an online 39-question survey. RESULTS: The 222 respondents (44% of those contacted) were mostly pediatricians (55%) and gynecologists (34%). Ninety percent reported having ever prescribed extended cycles of hormonal contraception to adolescents, and 33% said extended cycles make up more than 10% of their total combined hormonal contraceptive prescriptions. Respondents most commonly prescribed extended cycles to accommodate patients' requests to induce amenorrhea for specific events (82%) or for fewer menses per year (72%), and to treat menorrhagia (68%), dysmenorrhea (65%), and endometriosis (62%). The most commonly prescribed extended regimen was 84 continuous hormone days followed by 7 hormone-free days (46%), most often with an oral contraceptive containing 30 mug of ethinyl estradiol. Gynecologists were more likely than other physicians to prescribe extended cycles frequently, to prescribe hormone-free intervals shorter than 7 days, and to prescribe continuous regimens that eliminate the hormone-free interval completely. CONCLUSIONS: Physicians prescribe extended cycles of combined hormonal contraceptives to adolescents to accommodate patient requests and to treat common gynecologic conditions. Currently, a variety of extended cycling regimens are prescribed, suggesting that further study is needed to determine the optimal regimen for this subset of patients and their individual needs.
Publication Types:
• Research Support, Non-U.S. Gov't
PMID: 17259055 [PubMed - indexed for MEDLINE]
________________________________________
Am J Pathol. 2007 Feb;170(2):590-8.
Aberrant expression of leptin in human endometriotic stromal cells is induced by elevated levels of hypoxia inducible factor-1alpha.
Wu MH, Chen KF, Lin SC, Lgu CW, Tsai SJ.
Department of Obstetrics & Gynecology, Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan 701, Taiwan, Republic of China.
Elevated expression of leptin in endometriotic tissue results in an increase in stromal cell proliferation and may contribute to the development of endometriosis. However, the underlying mechanism responsible for aberrant expression of leptin is not known. We hypothesize that aberrant expression of leptin in endometriotic stroma may be regulated by increased levels of hypoxia-inducible factor-1alpha (HIF-1alpha), the master transcription factor that controls gene expression in response to hypoxia. Herein we show that the mRNA and protein levels of HIF-1alpha were greater in ectopic endometriotic tissue compared with its eutopic counterpart. Exposure of eutopic endometrial stromal cells under hypoxic conditions or treated with desferrioxamine (DFO, chemical hypoxia) resulted in a time-dependent increase in leptin gene expression. A promoter activity assay demonstrated that HIF-1alpha induced leptin promoter activity after DFO treatment. Chromatin immunoprecipitation assay further demonstrated that binding of HIF-1alpha to leptin promoter was evident after DFO treatment. Finally, depletion of HIF-1alpha by short interference RNA abolished leptin expression in ectopic endometriotic stromal cells. Taken together, our data demonstrate that aberrant expression of leptin in ectopic endometriotic stromal cells is induced, at least in part, by an elevated level of HIF-1alpha in these cells, providing new insights into the etiology of endometriosis.
Publication Types:
• Clinical Trial
• Research Support, Non-U.S. Gov't
PMID: 17255327 [PubMed - indexed for MEDLINE]
________________________________________
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000069.
Update of:
• Cochrane Database Syst Rev. 2000;(2):CD000069.
Danazol for unexplained subfertility.
Hughes E, Brown J, Tiffin G, Vandekerckhove P.
McMaster University, Department of Obstetrics and Gynaecology, 1200 Main St West, Room HSC-4F7, Hamilton, Ontario, CanadaL8N 3Z5. hughese@mcmaster.ca
BACKGROUND: The synthetic androgen Danazol, was developed in the 1970's as a treatment for endometriosis. Its use was soon advocated in women with unexplained subfertility. Two randomised trials were subsequently conducted to assess the effectiveness of danazol in this population. OBJECTIVES: The objective of this review was to assess the effect of danazol on live birth rate in women with unexplained subfertility. SEARCH STRATEGY: We searched the Cochrane Menstrual Disorders and Sub-fertility Group's specialised register of trials (searched November , 2006) the Cochrane Register of Controlled Trials (The Cochrane Library, Issue 4, 2006), MEDLINE (1966-November 2006), EMBASE (1980 - November 2006) and reference lists of articles. SELECTION CRITERIA: Randomised trials of danazol compared with placebo or no treatment in women with unexplained subfertility. DATA COLLECTION AND ANALYSIS: Data were extracted by two reviewers EH and GT. MAIN RESULTS: Two trials involving seventy-one women were included. There was no statistically significant difference in the live birth/ ongoing pregnancy rate between danazol and placebo at the end of treatment (OR 1.16, 95% CI 0.0 to 8.29; P=0.36) or at the end of follow-up (OR 2.41; 95% CI 0.59, 9.82; P=0.22). There was no significant difference in clinical pregnancies following treatment (OR 0.14, 95% CI 0.01, 2.26; P=0.17), however there were significantly more clinical pregnancies during the follow-up period in the danazol group compared with the placebo group (OR 3.15, 95%CI 0.98, 10.10; P<0.05). Multiple side effects were reported. AUTHORS' CONCLUSIONS: Available data demonstrate no evidence of the benefit of danazol for unexplained subfertility. Although there is insufficient evidence to be certain of this, the need for contraception during treatment and the adverse effects and costs of danazol, make its use for this problem unwarranted. The increased pregnancy rate in the long term follow-up data may be attributable to additional therapies and did not influence the live birth/ongoing pregnancy data.
Publication Types:
• Review
PMID: 17253444 [PubMed - indexed for MEDLINE]
________________________________________
Asian Pac J Cancer Prev. 2006 Oct-Dec;7(4):638-40.
Clinicopathological features and prognosis of Thai women with endometrioisis-associated ovarian carcinoma.
Surprasert P, Khunamornpong S, Srisomboon J.
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. psuprase@mail.med.cmu.ac.th
This study was undertaken to evaluate the clinical features and survival outcomes of ovarian cancer patients who had associated pelvic endometrioisis. The medical records of 1076 patients with ovarian cancer treated at Chiang Mai University Hospital between 1995 and 2005 were reviewed. Among of these patients, 37 (3.4%) had associated pelvic endometriosis. The mean age of the patients was 44 years (25-62 years). The most common presenting sign and symptom was an abdominal mass (12), followed by abdominal pain (10), abdominal distension (7), abnormal uterine bleeding (2). Twenty-one (56.8%) patients were nulliparous and 14 (37.8%) were single. The stage distribution was stage I (24), stage II (4), stage III (4), and stage IV (1). Four patients had 2 primary carcinomas. The most common histology of the 37 patients was clear cell carcinoma (17) followed by endometrioid carcinoma (11). The estimated 5-year disease - free survival was 55.4%. In conclusion, most patients associated with endometriosis- associated ovarian carcinoma present with abdominal masses and pain. Clear cell CA is the most common histology in ovarian cancer patients who have associated endometriosis. Three fourths of the patients are in stage I and have favorable prognosis.
PMID: 17250443 [PubMed - indexed for MEDLINE]
________________________________________
J Eur Acad Dermatol Venereol. 2007 Feb;21(2):280-1.
Umbilical endometriosis.
Farhi D, Zimmermann U, Chapron C, Dupin N.
Publication Types:
• Case Reports
• Letter
PMID: 17243985 [PubMed - indexed for MEDLINE]
________________________________________
Surg Today. 2007;37(2):141-4. Epub 2007 Jan 25.
Successful video-assisted thoracic surgery for pulmonary endometriosis: Report of a case.
Haruki T, Fujioka S, Adachi Y, Miwa K, Taniguchi Y, Nakamura H.
Division of General Thoracic Surgery, Tottori University Hospital, 36-1 Nishi-machi, Yonago, Tottori, 683-8504, Japan.
Pulmonary endometriosis is a disease in which uterine endometrial cells with stromal components grow in the pulmonary parenchymal tissues or pleura. Surgical resection is considered an effective and radical treatment for pulmonary endometriosis to avoid the adverse effects of long-term hormone therapy in young women of childbearing years with a localized abnormal lesion. We report a case of pulmonary endometriosis with catamenial hemoptysis, an uncommon result of this disease, which was diagnosed histologically and treated successfully by video-assisted thoracic surgery.
Publication Types:
• Case Reports
PMID: 17243034 [PubMed - indexed for MEDLINE]
________________________________________
Fertil Steril. 2007 Jan 17; [Epub ahead of print]
A pilot study on the off-label use of valproic acid to treat adenomyosis.
Liu X, Guo SW.
Department of Gynecology, Shanghai Obstetrics and Gynecology Hospital and Department of Gynecology and Obstetrics, Shanghai Medical School, Fudan University, Shanghai, China;
Following on the heels of the discovery that endometriosis is an epigenetic disease, we conducted a pilot study on the off-label use of valproic acid to treat adenomyosis. We found that by the end of the 3-month treatment, all three recruited patients reported complete disappearance of dysmenorrhea, with an average of one-third reduction in uterus size.
PMID: 17239872 [PubMed - as supplied by publisher]
________________________________________
Nat Clin Pract Endocrinol Metab. 2007 Feb;3(2):157-67.
Drug Insight: clinical use of agonists and antagonists of luteinizing-hormone-releasing hormone.
Engel JB, Schally AV.
Medical University of Wurzburg Department of Obstetrics and Gynecology, Wurzburg, Germany. joergbengel@hotmail.com
This article reviews the clinical uses of agonists and antagonists of luteinizing-hormone-releasing hormone (LHRH), also known as gonadotropin-releasing hormone. In particular, the state of the art treatment of breast, ovarian and prostate cancer, reproductive disorders, uterine leiomyoma, endometriosis and benign prostatic hypertrophy is reported. Clinical applications of LHRH agonists are based on gradual downregulation of pituitary receptors for LHRH, which leads to inhibition of the secretion of gonadotropins and sex steroids. LHRH antagonists immediately block pituitary LHRH receptors and, therefore, achieve rapid therapeutic effects. LHRH agonists and antagonists can be used to treat uterine leiomyoma and endometriosis; furthermore, both types of LHRH analogs are used to block the secretion of endogenous gonadotropins in ovarian-stimulation programs for assisted reproduction. The preferred primary treatment of patients with advanced, androgen-dependent prostate cancer is based on the periodic administration of depot preparations of LHRH agonists; these agonists can be likewise used to treat estrogen-sensitive breast cancer in premenopausal women. LHRH antagonists have been successfully used to treat prostate cancer and benign prostatic hypertrophy. Since receptors for LHRH are present on a variety of human tumors, (notably breast, prostate, ovarian, endometrial and renal cancers), cytotoxic therapy that targets these tumors with hybrid molecules of LHRH might be possible in the near future. Analogs of LHRH are now a well-established means of treating sex-steroid-dependent, benign and malignant disorders.
Publication Types:
• Review
PMID: 17237842 [PubMed - indexed for MEDLINE]
________________________________________
Virchows Arch. 2007 Mar;450(3):349-53. Epub 2007 Jan 18.
Extrauterine endometrial stromal sarcoma with JAZF1/JJAZ1 fusion confirmed by RT-PCR and interphase FISH presenting as an inguinal tumor.
Sato K, Ueda Y, Sugaya J, Ozaki M, Hisaoka M, Katsuda S.
Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan, sato-k@kanazawa-med.ac.jp.
Endometrial stromal sarcomas are rare malignant mesenchymal tumors that usually develop in the uterine corpus and occasionally arise at various extrauterine sites. This report describes the first case of primary extrauterine endometrial stromal sarcoma arising in the extraperitoneal portion of the round ligament presenting as a solitary inguinal mass in a 46-year-old woman. The patient presented gradually growing tumor in the right inguinal region. Local tumor resection was performed and no recurrence or metastasis was found at 15 months after the operation. Histological examination revealed that the tumor comprised uniform, spindle-shaped cells with blunt nuclear figure and scattered small arteries, and infiltrated into adjacent tissue. No endometriosis was morphologically identified in the lesion. Immunohistochemically, the tumor cells were positive for CD10, estrogen receptor, progesterone receptor, alpha-smooth muscle actin, and calponin. We confirmed JAZF1/JJAZ1 fusion by reverse transcription-polymerase chain reaction and the corresponding chromosomal translocation by interphase fluorescence in situ hybridization on paraffin sections. It is essential that the inguinal region should be recognized as a possible primary site of endometrial stromal sarcoma, and the detection of a JAZF1/JJAZ1 fusion can be useful when the diagnosis is not confirmed by microscopic observation or immunohistochemistry for the tumor arising in extrauterine sites.
PMID: 17235569 [PubMed - in process]
________________________________________
Int J Colorectal Dis. 2007 Jan 18; [Epub ahead of print]
Ileus due colon endometriosis and the role of MRI scan.
Hampe T, Kulaksiz H.
Med. Klinik IV, INF 410, 69120, Heidelberg, Germany, toni.hampe@hotmail.de.
PMID: 17235507 [PubMed - as supplied by publisher]
________________________________________
Hum Reprod. 2007 Apr;22(4):1091-4. Epub 2007 Jan 18.
Prognostic capacity of transvaginal hydrolaparoscopy to predict spontaneous pregnancy.
van Tetering EA, Bongers MY, Wiegerinck MA, Mol BW, Koks CA.
Department of Obstetrics and Gynaecology, Maxima Medical Center, Veldhoven, The Netherlands. ovantetering@gmail.com
BACKGROUND: In 1998, transvaginal hydrolaparoscopy (THL) was introduced as a new outpatient procedure for exploration of tubo-ovarian structures and tubal patency in subfertile patients. At present, there are no large studies that relate the findings at THL to fertility outcome. METHODS: Consecutive patients undergoing THL for subfertility between 2000 and 2004 were included in this prospective cohort study. Follow-up ended when ongoing pregnancy or tubal surgery occurred or at the day of last contact. Kaplan-Meier curves for the occurrence of intrauterine pregnancy (IUP) (spontaneous or after intrauterine insemination) were constructed for a normal THL, a THL with a one-sided tubal pathology and a THL with a two-sided tubal pathology. Fecundity rate ratios (FRRs) were calculated to express the association between THL findings and the occurrence of IUP. Patients rated their pain experiences and acceptability on a visual analogue scale (VAS). RESULTS: We included 272 women. In 96% (261) of the patients, access to the pouch of Douglas was achieved. Complications occurred in 2% of the procedures. In 203 (78%) patients, both tubo-ovarian structures could be visualized and tubal patency was shown. One-sided tubal occlusion was found in 10%, whereas two-sided tubal occlusion was seen in 4% of the patients. Adhesions and/or endometriosis were observed in 8% of the patients. The FRRs for one-sided tubal pathology, two-sided tubal pathology and adhesions/endometriosis were 0.59, 0 and 0.80, respectively. The VAS scores showed pain to be limited and the procedure to be acceptable. CONCLUSION: THL is a feasible technique. Its capacity to predict spontaneous ongoing pregnancy is comparable to that of laparoscopy.
PMID: 17234678 [PubMed - in process]
________________________________________
Hum Reprod. 2007 May;22(5):1474-80. Epub 2007 Jan 18.
High-dose atorvastatin causes regression of endometriotic implants: a rat model.
Oktem M, Esinler I, Eroglu D, Haberal N, Bayraktar N, Zeyneloglu HB.
Department of Obstetrics and Gynecology.
BACKGROUND This prospective randomized-controlled animal study was designed to determine the effects of atorvastatin on experimentally induced endometriosis in a rat model. METHODS Thirty-seven Wistar-Albino rats in which endometriotic implants were induced were randomly divided into four groups. Group I (Low-dose atorvastatin group, eight rats) were given 0.5 mg kg(-1) day(-1) oral atorvastatin. Group II (High-dose atorvastatin group, 10 rats) were given 2.5 mg kg(-1) day(-1) oral atorvastatin. Group III were given a single dose of 1 mg kg(-1) s.c. leuprolide acetate (GnRH agonist group, nine rats). Group IV were given no medication and served as controls (10 rats). All rats received the treatment for 21 days and were then euthanized to assess the implants' size, vascular endothelial growth factor (VEGF) level in peritoneal fluid and histological score. RESULTS At the end of the treatment, the mean areas of implants were smaller and VEGF levels in peritoneal fluid were lower in Groups II and III than those in Group I and the control group (all P < 0.05). The mean areas of implants decreased from 41.2 +/- 13.9 to 22.7 +/- 13.9 mm(2) after medication in Group II and decreased from 41.2 +/- 18.1 to 13.1 +/- 13.8 mm(2) in Group III (both P < 0.05), whereas in Group I, the mean area increased from 43.0 +/- 12.7 to 50.5 +/- 13.9 mm(2) (P < 0.05). CONCLUSIONS High-dose atorvastatin caused a significant regression of endometriotic implants.
PMID: 17234677 [PubMed - in process]
________________________________________
Hum Reprod. 2007 May;22(5):1373-9. Epub 2007 Jan 18.
Endometriosis: an inflammatory disease with a Th2 immune response component.
Podgaec S, Abrao MS, Dias JA Jr, Rizzo LV, de Oliveira RM, Baracat EC.
Department of Obstetrics and Gynecology, Teaching Hospital.
BACKGROUND Efforts have been made to correctly characterize the role of the immune response in endometriosis. The objective of this study was to analyse the interaction between Th1 and Th2 immune response patterns and endometriosis by evaluating a panel of cytokines. METHODS Between January 2004 and November 2005, 98 patients, classified into two groups according to the histologically confirmed presence (Group A) or absence of endometriosis (Group B), were evaluated. Interleukins (IL) 2, 4 and 10, tumour necrosis factor-alpha and interferon-gamma (IFN-gamma) were measured by flow cytometry in the peripheral blood and peritoneal fluid of all patients. RESULTS IFN-gamma and IL-10 levels were significantly higher in the peritoneal fluid of patients with endometriosis compared to those without endometriosis (P < 0.05). There was a significant alteration in the IL-4/IFN-gamma (P < 0.001), IL-4/IL-2 (P = 0.006), IL-10/IFN-gamma (P < 0.001) and the IL-10/IL-2 ratios (P < 0.001) in the peritoneal fluid of patients with endometriosis, with a predominance of IL-4 and IL-10, reflecting a shift towards Th2 immune response despite the increase in IFN-gamma concentrations. CONCLUSIONS Endometriosis is an inflammatory disease involving a possible shift towards Th2 immune response component, as demonstrated by the relative increase in cytokines characteristic of this pattern of immune response.
PMID: 17234676 [PubMed - in process]
________________________________________
Acta Obstet Gynecol Scand. 2007;86(1):111; author reply 112.
Comment on:
• Acta Obstet Gynecol Scand. 2006;85(1):88-92.
Prevalence of depression in women with endometriosis.
Ferrero S, Remorgida V, Ragni N.
Publication Types:
• Comment
• Letter
PMID: 17230302 [PubMed - indexed for MEDLINE]
________________________________________
Acta Obstet Gynecol Scand. 2007;86(1):73-80.
Risk factors for abdominal scar endometriosis after obstetric hysterotomies: a case-control study.
de Oliveira MA, de Leon AC, Freire EC, de Oliveira HC, Study SO.
Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro, Brazil. Maurelio@infolink.com.br
OBJECTIVE: To identify risk factors that are associated with the development of scar endometriosis after obstetric hysterotomies. The hypothesis is that early hysterotomy in pregnancy (before 22nd week) is the main risk factor for the development of scar endometriosis. METHODS: The authors conducted a case-control study between April 2000 and June 2003. A total of 117 women were selected, including 39 cases and 78 controls. Exposure and confounding variables were measured by a standardized questionnaire, which included sociodemographic characteristics, reproductive/physiologic history, past pathological history, history of obstetric surgeries, family history, and social history. The odds ratio (OR) and its 95% confidence interval (CI) were calculated using bivariate analysis for each possible risk factor. These estimates were obtained by multivariate analysis using unconditional logistic regression. Tests were made to assess the fit of the final model. RESULTS: In the multivariate analysis, positive associations were observed between scar endometriosis and hysterotomy type (early versus late: OR = 42.99; CI 8.77-210.81), amount of the menstrual blood flow (heavy versus light/normal: OR = 11.97; CI 2.35-60.82), and alcoholic consumption (yes versus no: OR = 5.31; CI 1.22-23.11). Negative association was observed between scar endometriosis and parity (OR = 0.61; CI 0.31-1.23), however it was not statistically significant (p>0.05). CONCLUSIONS: Early hysterotomy in pregnancy is the main risk factor for scar endometriosis. Increased menstrual flow and alcohol consumption are also risk factors, while high parity may be a protecting factor.
PMID: 17230293 [PubMed - indexed for MEDLINE]
________________________________________
Acta Obstet Gynecol Scand. 2007;86(1):4-15.
Surgical interruption of pelvic nerve pathways in dysmenorrhea: a systematic review of effectiveness.
Latthe PM, Proctor ML, Farquhar CM, Johnson N, Khan KS.
Academic Department of Obstetrics & Gynaecology, University of Birmingham, Birmingham, UK. pallavi@doctors.org
OBJECTIVES: To assess the effectiveness of surgical interruption of pelvic nerve pathways in primary and secondary dysmenorrhea. Data sources. The Cochrane Menstrual Disorders and Subfertility Group Trials Register (9 June 2004), CENTRAL (The Cochrane Library, Issue 2, 2004), MEDLINE (1966 to Nov. 2003), EMBASE (1980 to Nov. 2003), CINAHL (1982 to Oct. 2003), MetaRegister of Controlled Trials, the citation lists of review articles and included trials, and contact with the corresponding author of each included trial. REVIEW METHODS: The inclusion criteria were randomized controlled trials of uterosacral nerve ablation or presacral neurectomy (both open and laparoscopic procedures) for the treatment of dysmenorrhea. The main outcome measures were pain relief and adverse effects. Two reviewers extracted data on characteristics of the study quality and the population, intervention, and outcome independently. RESULTS: Nine randomized controlled trials were included in the systematic review. There were two trials with open presacral neurectomy; all other trials used laparoscopic techniques. For the treatment of primary dysmenorrhea, laparoscopic uterosacral nerve ablation at 12 months was better when compared to a control or no treatment (OR 6.12; 95% CI 1.78-21.03). The comparison of laparoscopic uterosacral nerve ablation with presacral neurectomy for primary dysmenorrhea showed that at 12 months follow-up, presacral neurectomy was more effective (OR 0.10; 95% CI 0.03-0.32). In secondary dysmenorrhea, along with laparoscopic surgical treatment of endometriosis, the addition of laparoscopic uterosacral nerve ablation did not improve the pain relief (OR 0.77; 95% CI 0.43-1.39), while presacral neurectomy did (OR 3.14; 95% CI 1.59-6.21). Adverse events were more common for presacral neurectomy than procedures without presacral neurectomy (OR 14.6; 95% CI 5-42.5). CONCLUSION: The evidence for nerve interruption in the management of dysmenorrhea is limited. Methodologically sound and sufficiently powered randomized controlled trials are needed.
Publication Types:
• Research Support, Non-U.S. Gov't
• Review
PMID: 17230282 [PubMed - indexed for MEDLINE]
________________________________________
Expert Rev Mol Med. 2007 Jan 16;9(2):1-20.
Endometriosis: disease pathophysiology and the role of prostaglandins.
Wu MH, Shoji Y, Chuang PC, Tsai SJ.
Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan 701, Taiwan, Republic of China.
Endometriosis is considered to be a polygenic disease with a complex, multifactorial aetiology that affects about 10% of women in the reproductive age. Women with endometriosis have symptoms that include chronic pelvic pain, dysmenorrhoea and dyspareunia, significantly reducing their quality of life. Endometriosis is also the primary cause of infertility in women, with the prevalence rate ranging from 20% to 50%. The high prevalence and severe outcomes of this disease have made it a major public health concern in modern society. Currently, the mechanism(s) responsible for the initiation and promotion of this disease remains obscure. In this review, we focus on the expression, regulation and action of prostaglandins in the cellular and molecular mechanisms that contribute to the development and/or maintenance of endometriosis.
PMID: 17227592 [PubMed - in process]
________________________________________
Arch Pathol Lab Med. 2007 Jan;131(1):138-44.
Primary peritoneal serous borderline tumors.
Hutton RL, Dalton SR.
Department of Pathology and Laboratory Services, Brooke Army Medical Center, 3856 Roger Brooke Dr, Fort Sam Houston, TX 78234, USA. robert.hutton@amedd.army.mil
CONTEXT: Primary peritoneal serous borderline tumor is a rare epithelial proliferation that can present as an incidental finding at laparotomy and raises concern for a primary ovarian tumor with peritoneal implants. OBJECTIVE: To present a brief history of this condition and describe its distinctive histology and clinical presentation, as well as to review the chief differential diagnostic considerations, to include mesothelial proliferations, endosalpingiosis, endometriosis, high-grade primary peritoneal papillary serous carcinoma, and implants from primary ovarian serous neoplasms. DATA SOURCES: Relevant articles indexed in PubMed (National Library of Medicine) between 1966 and 2005, references thereof, and reference surgical pathology texts. CONCLUSIONS: Primary peritoneal serous borderline tumor should be considered in the differential diagnosis of an epithelial proliferation with prominent psammoma bodies on the peritoneal surface of specimens submitted for nongynecologic complaints.
Publication Types:
• Review
PMID: 17227115 [PubMed - indexed for MEDLINE]
________________________________________
J Urol. 2007 Feb;177(2):450-6.
Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: a systematic review.
Bogart LM, Berry SH, Clemens JQ.
Rand Corp., Santa Monica, California, USA. lbogart@rand.org
PURPOSE: In women symptoms of interstitial cystitis are difficult to distinguish from those of painful bladder syndrome and they appear to overlap with those of urinary tract infection, chronic urethral syndrome, overactive bladder, vulvodynia and endometriosis. This has led to difficulties in formulating a case definition for interstitial cystitis, and complications in the treatment and evaluation of its impact on the lives of women. We performed a systematic literature review to determine how best to distinguish interstitial cystitis from related conditions. MATERIALS AND METHODS: We performed comprehensive literature searches using the terms diagnosis, and each of interstitial cystitis, painful bladder syndrome, urinary tract infection, overactive bladder, chronic urethral syndrome, vulvodynia and endometriosis. RESULTS: Of 2,680 screened titles 604 articles were read in full. The most commonly reported interstitial cystitis symptoms were bladder/pelvic pain, urgency, frequency and nocturia. Interstitial cystitis and painful bladder syndrome share the same cluster of symptoms. Chronic urethral syndrome is an outdated term. Self-reports regarding symptoms and effective antibiotic use can distinguish recurrent urinary tract infections from interstitial cystitis in some but not all women. Urine cultures may also be necessary. Pain distinguishes interstitial cystitis from overactive bladder and vulvar pain may distinguish vulvodynia from interstitial cystitis. Dysmenorrhea distinguishes endometriosis from interstitial cystitis, although many women have endometriosis plus interstitial cystitis. CONCLUSIONS: In terms of symptoms interstitial cystitis and painful bladder syndrome may be the same entity. Recurrent urinary tract infections may be distinguished from interstitial cystitis and painful bladder syndrome via a combination of self-report and urine culture information. Interstitial cystitis and painful bladder syndrome may be distinguished from overactive bladder, vulvodynia and endometriosis, although identifying interstitial cystitis and painful bladder syndrome in women with more than 1 of these diseases may be difficult.
Publication Types:
• Research Support, N.I.H., Extramural
• Review
PMID: 17222607 [PubMed - indexed for MEDLINE]
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Arch Gynecol Obstet. 2007 Jan 12; [Epub ahead of print]
Successful outcome following pre-viability amniorrhexis.
Engemise S, Kalu E, Haque K.
Department of Obstetrics and Gynaecology, St Helier Hospital, Wrythe Lane, Carshalton, Surrey, SM5 1AA, UK, engemisesam@doctors.org.uk.
A 34-years-old primigravida conceived following a fourth attempt at in vitro fertilization and embryo transfer for severe bilateral tubal disease and grade IV endometriosis. Pregnancy progressed well until 17 weeks gestation when she spontaneously ruptured her membranes. She elected to continue with the pregnancy despite the significant risks associated with prolonged rupture of membranes (PROM) and anhydramnion at extremes of viability. Pregnancy was carried to 28 weeks gestation, when delivery was necessitated by a major antepartum haemorrhage following abruption placentae. A male infant weighing 1,100 g was delivered by emergency caesarean section in good condition, and with no features oligohydramnion tetrad (Potter's features, skeletal deformities, intrauterine growth restriction, and pulmonary hypoplasia). This case adds to the small number of cases in the literature of successful outcome following prolonged pre-viability PROM. Counselling and psychological support to the parents in this situation is extremely important since the anxiety and uncertainty associated with expectant management of PROM does not end with the "successful" delivery of the baby but persists all through the neonatal period and for several years later.
PMID: 17219157 [PubMed - as supplied by publisher]
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J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):128-31.
Septate uterus with double cervices, unilaterally obstructed vaginal septum, and ipsilateral renal agenesis: a rare combination of mullerian and wolffian anomalies complicated by severe endometriosis in an adolescent.
Hur JY, Shin JH, Lee JK, Oh MJ, Saw HS, Park YK, Lee KW.
Department of Obstetrics and Gynecology, Korea University Medical Center, Seoul, Korea.
We present a previously unreported combination of mullerian and wolffian anomalies of a septate uterus with double cervices, unilaterally obstructed vaginal septum, and ipsilateral renal agenesis; this constellation of findings may offer clues that could modify classic embryologic explanations. In spite of the young age of our patient (15-years old), a chief complaint of malodorous vaginal discharge, and absence of dysmenorrhea or any other symptoms of endometriosis, laparoscopic examination revealed severe endometriosis with dense adhesions, probably as a result of abundant menstrual regurgitation. Laparoscopic resection of endometriotic lesions, adhesiolysis, and vaginoscopic septotomy were successfully performed while preserving hymenal integrity.
Publication Types:
• Case Reports
PMID: 17218245 [PubMed - indexed for MEDLINE]
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J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):113-5.
Laparoscopic treatment of recurrent small bowel obstruction secondary to ileal endometriosis.
Orbuch IK, Reich H, Orbuch M, Orbuch L.
Advanced Gynecologic Laparoscopy Center, New York, New York, USA. iriskerin@hotmail.com
Endometriosis is a relatively common condition characterized by implantation and proliferation of endometrial glands outside the uterus affecting 8% to 15% of women. Intestinal involvement is common, reported in 12% to 37% of individuals with the disease. The sites most often affected are the sigmoid colon and rectum (85%), while small bowel involvement is seen less frequently (7%) and usually confined to the distal ileum. The cecum (3.6%) and appendix (3%) are the sites least affected.
Publication Types:
• Case Reports
PMID: 17218241 [PubMed - indexed for MEDLINE]
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J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):54-8.
Pentoxifylline therapy after laparoscopic surgery for different stages of endometriosis: a prospective, double-blind, randomized, placebo-controlled study.
Alborzi S, Ghotbi S, Parsanezhad ME, Dehbashi S, Alborzi S, Alborzi M.
Division of Infertility and Endoscopic Surgery, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. alborzis@sums.ac.ir
STUDY OBJECTIVE: To evaluate the effects of pentoxifylline administration on patients with different stages of endometriosis on whom laparoscopy was performed. DESIGN: Prospective, double-blind, randomized, placebo-controlled clinical (Canadian Task Force classification I). SETTING: University and private hospitals. PATIENTS: Eighty-eight women, all with infertility, some with dysmenorrhea, dyspareunia, or pelvic pain, on whom a laparoscopic diagnosis of endometriosis was made. INTERVENTIONS: The treatment group received 800 mg pentoxifylline daily for 6 months immediately after surgery. The control group received placebo capsules. All patients were followed-up for 1 year thereafter. MEASUREMENTS AND MAIN RESULTS: A comparison of pregnancy rate and recurrence of signs and symptoms in the 2 groups was performed. Forty-three patients were studied in the pentoxifylline group and 45 in the placebo group. The cumulative pregnancy rate was 39.5% and 35.6% in the treatment and control groups, respectively. The overall recurrence of signs and symptoms was 14% in the former group and 15.6% in the latter. There were no statistically significant differences between the 2 groups in rates of pregnancy and recurrence (p = .700 and .832, respectively). Nor was there any significant statistical difference between the same stages in the 2 groups regarding immunomodulation. CONCLUSIONS: According to the results of this study, and while keeping in mind that appropriate surgery is the main aspect of endometriosis treatment, there is no evidence that immunomodulation with pentoxifylline aids fertility or lessens recurrence of signs and symptoms in women with different stages of endometriosis (i.e., minimal, mild, moderate, or severe).
Publication Types:
• Randomized Controlled Trial
PMID: 17218230 [PubMed - indexed for MEDLINE]
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J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):49-53.
The prevalence of fimbrial pathology in patients with early stages of endometriosis.
Abuzeid MI, Mitwally MF, Ahmed AI, Formentini E, Ashraf M, Abuzeid OM, Diamond MP.
Center for Reproductive Medicine, Hurley Medical Center, Flint, Michigan 48503, USA. reprod1@hurleymc.com
STUDY OBJECTIVE: The presence of fimbrial pathology in advanced endometriosis is clearly understood. However, little is known about the prevalence of fimbrial pathology in early stages of endometriosis. The purpose of this study is to determine the prevalence of fimbrial pathology in patients with infertility with early stages of endometriosis. DESIGN: Historical cohort study (Canadian Task Force classification II/III). SETTING: Tertiary referral center. PATIENTS: The study group (Group 1) consisted of 315 infertile women who were found to have stage I or stage II endometriosis, and the control group (Group 2) consisted of 152 infertile women without endometriosis (Group 2). INTERVENTION: Laparoscopic evaluation for the presence and type of fimbrial pathology. MEASUREMENTS AND MAIN RESULTS: The prevalence of fimbrial pathology was significantly higher in infertile patients with early stages of endometriosis (50.2%) compared with infertile patients with no endometriosis (17.8%, p <.0001). CONCLUSION: These preliminary data suggest the presence of fimbrial pathology in many patients with early stages of endometriosis. Such pathology may act as a mechanical factor interfering with the ovum pick-up mechanism.
PMID: 17218229 [PubMed - indexed for MEDLINE]
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